| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $3K | $14K | 12.57% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 1.72% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $2K | $7K | 19.28% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $553 | $553 | 1.43% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $6K | 20.10% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $494 | $494 | 1.70% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 20.48% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $391 | $391 | 1.82% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $711 | $2K | 15.16% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $237 | $237 | 1.72% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $650 | $2K | 20.31% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $217 | $217 | 1.77% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $605 | $2K | 20.09% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $202 | $202 | 1.70% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $495 | $2K | 19.77% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $165 | $165 | 1.59% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY SUITE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 17.96% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 151 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 126 | $110K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 129 | $14K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 151 | $33K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 150 | $39K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 151 | $29K |
| Other(5 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 151 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.